Going Gluten-Free

Gluten intolerance, wheat allergy, and celiac disease statistics are on the rise—but not everyone needs to delete wheat from their diets

Hillari Dowdle

10:24 AM, Apr 11, 2012

For years, my sister-in-law had been trying to tell me. The source of my vague aches and pains, my migraine headaches, my bouts with gastroesophageal reflux disorder, and my general lack of energy was a simple one: wheat. "Stop eating all that wheat, and you'll feel better," she promised over and over and over.

But it was unthinkable. No pasta? No bread? No pizza? "No way," I told her. "You can have my bagel when you pry it from my cold dead fingers." Giggle on my part, eye roll on her part, and we all moved on … until next year, when the same conversation would happen again, with more convincing and more denial. Wheat is the staff of life, after all. How could it be hurting me? Sure, we'd sub in quinoa and rice during her visits, no problem. But then it was straight back to the subs, mac and cheese, and dumplings.

Imagine my surprise, then, 20 odd years later, to find out that she'd been right all along. As a freelance writer for Natural Health magazine, I reported a story on the rising rates of food allergies, focusing on wheat in particular. More and more cases of gluten intolerance, wheat allergy, and celiac disease (an auto-immune disorder in which exposure to gluten causes the body to attack the villi of the small intestine, leading to serious malnutrition) are being reported; what's less clear is why. Is it just more awareness? Is it that our standard American diet has become so much more wheat dependent over the years? Is it the fault of the hardy strains of wheat we've narrowed the crop down to over the years? Is it just simply wheat overload?

No one really knows, though many will theorize. When I interviewed Beth Reardon, R.D., an integrative nutritionist in practice at Duke, she told me, "Wheat is a latecomer to in terms of human DNA; we've only had it for about 10,000 years, which isn't long in evolutionary terms. Now we're eating so much of it—much more than we were designed to handle. And when you overdose on a food that is a bit problematic in the first place, of course you're going to start seeing allergies and intolerances."

She's right, of course. If I had to go out and thresh it myself, rather than pop the can of Pillsbury Crescent Rolls, I sure as heck wouldn't have been eating it three, four, or more times a day. I wouldn't have been be following my pasta dinner with cake and cookies. And chances are slim that I'd have been motivated to pound out my own Wheaties for breakfast.

But it was another interview that convinced me to look within, and consider—for the first time, really—that I might have a problem with the stuff. Steve Nenninger, N.D., is a practicing naturopath working out of state (Tennessee does not license naturopathic doctors). Wheat allergies, despite the apparent epidemic, are underdiagnosed, he explained, because the body doesn't react immediately to it in the same way that it might a bee sting—which is to say that it has an IgE allergic response, which in the worst-case scenario can cause anaphylaxis and even death. No, wheat does its work over time, registering a low-level response from the body in terms of IgG reaction, meaning that it's not wreaking immediate havoc, but chipping slowly away at the immune system and structural integrity of the digestive tract by causing inflammation. A simple blood test could tell me if I was IgG positive for a gluten allergy, and test for reactions to many other foods, besides. So I logged on to Nenninger's website, ordered his test, and sent off five drops of blood on a piece of blotter paper.

Two weeks later, the news was in: I was reacting to eggs, dairy, nuts, beans, and above all else, gluten. "You are one of the most gluten-allergic people I've seen in my practice," he told me. "Your digestive tract is in bad shape from all the gluten you've been eating, which is why you're reacting to everything else. You have to get gluten out of your diet, starting now."

Duhn-duhn-DUHN!

***

To say I was stunned understates the case. What's life in Knoxville without Tomato Head's #1 pizza, Litton's cheeseburgers, and Magpies' cupcakes? These were staples in my diet. To hear that could be no more was devastating.

I digested this information, then called Nenninger back, nearly hysterical. "Look, I know this is a big change, and you can work at it slowly," he told me in dulcet tones that let me know I wasn't the first hysterical woman he'd talked down off the ledge. "Do the best you can. And starting today, educate yourself. In a matter of months, it won't be a problem. And you'll feel so much better that it will have been worth it. Trust me."

So I did what any savvy Knoxvillian would do, and drove to Earth Fare, thinking there I could find safe and nourishing foods that would lull me back to health. But though there are plenty of gluten-free products to be had there, and labeled so, there are many others that either contain wheat even though you wouldn't expect it (salad dressing, soups, chocolates, cheeses, etc.), or are labeled with some disclaimer, like "This produced was produced in a facility that also processes wheat, nuts, soy, and egg products." A CYA maneuver, to be sure, but one that leaves open the real possibility of cross-contamination.

I shopped as best I could, then shifted my focus to "safe" restaurants, like sushi houses. What could be more safe than sushi with rice? Turns out, a helpful waiter at Nama explained, that gluten is often added to rice to make it stickier, and that delicious soy sauce you're used to dipping it into has more wheat than soy. You have to be careful; you have to let the chefs know about your issue. You can't really order off the menu, even here. Ugh! Ugh! Ugh! It was too much to bear.

Then my mother did me a simple kindness of buying me a book while lunching with a friend at Miss Olivia's Table in Maryville: My Gluten Free Knoxville, by Janet McKenzie Prince. It's a real guidebook for finding the resources I'd need to make it through my new wheatless life, not only with minimum pain, but with maximum pleasure.

Prince herself suffers from celiac disease, the most damaging form of gluten intolerance, and was in bad shape, she says, before she was diagnosed. "I was diagnosed in 2000, before the idea of gluten intolerance or information about celiac disease had become mainstream," she says. "I was in extreme pain, walking with a cane, and had lost so much weight I was weak and malnourished. Most doctors scratched their heads; one told me I had all the symptoms of pancreatic cancer, except the cancer. When I got a diagnosis, I was so happy. Finally, I could take charge of my health!"

It's easy to see why Prince had a hard time getting help around here. In East Tennessee, allergies are all about pollen—in the case of which we are number one in the nation for suffering, wheezing, sneezing, and generally looking like we just smoked a bong hit of bad weed. The medical allergy community here is all about dosing, scratch testing, and shots. When I reach out to the city's largest allergy practice, the Allergy, Asthma & Sinus Center, I'm connected with Karthik Krishnan, M.D., who's sensitive to wheat-sensitive clientele, but feels there's a faddishness to the gluten-free frenzy. In his world, there's celiac disease, diagnosable through IgA blood testing along with a biopsy of the small intestine, and self-diagnosis. He pooh-poohs the IgG blood test I took ("meaningless," he called it), but acknowledges that there is something real going on for some people.

"Non-celiac wheat sensitivities can produce very real symptoms, such as skin rashes, diarrhea, vomiting, cramping, and headaches—some are vague, some are pointed, and some are coincidental," Krishnan says. "But there's no useful medical test to prove what's going on. I tell my patients to get off of wheat for a month and see if they feel better. Otherwise, there's no good way to tell if wheat is what's making you sick."

Self-diagnosis, in other words, then self-treatment. Krishnan estimates that 5 to 6 percent of the Knoxville population falls into this non-celiac sensitivity category. But he says if you think that's you, you can save yourself a co-pay. "Anybody can try this elimination diet for themselves," he says. "You don't need a trip to the doctor to do it."

Another allergist in town, Marek Pienkowski, M.D. gives a bit more credence to IgA, IgE, and IgG testing, but even he says interpreting the results outside of celiac disease is a nuanced business that requires experimentation. "If you're overeating wheat, it can help to vary your diet," he says. "But I think that a lot of the wheat-free diets people are going on aren't really medically justified."

Still, for some, deleting wheat can make life-altering improvements. "Wheat has been associated with arthritis, migraine headaches, emotional problems, and even autism in children," Pienkowski says. Taking a trial wheat-free leap can't hurt, and it might help. You'll know, Pienkowski says, because you'll feel it in your bones. "Go on a gluten-free trial diet, then go back to gluten. If you start having symptoms within a week after reintroducing wheat, then you might want to consider eliminating it from your diet for good."

Elimination is the best medicine—and almost the only medicine. If you're allergic to pollen, you can pop your daily Zyrtec and go right on breathing. But there's no magic pill that will make wheat okay again for celiac sufferers. For those of us among the gluten-intolerant, there might be hope.

This may sound a little bit woo-woo, but go with me: NAET is a combination of homeopathy, muscle testing, breathing techniques, physical manipulation, and stimulation of certain points along the meridians of Traditional Chinese Medicine. The treatment was developed by Devi S. Nambudripad—a scientist with a string of letters behind her name, including M.D., D.C., Ph.D., and L.Ac., and the acronym stands for Nambudripad Allergy Elimination Technique. I learned about it a while back (again during service to Natural Health) from Jacob Teitelbaum, M.D., author of From Fatigued to Fantastic, Beat Sugar Addiction Now, and Pain Free 1-2-3. Having known and worked with him for years, I consider his word as good as gold, and when he told me about NAET, he was straight up. He'd used it to treat his debilitating hayfever, and it changed his life. "I know it sounds crazy," he said. "But it just works." And now he refers all his food allergy patients to NAET practitioners.

For Knoxvillians, NAET hadn't been an option until recently, when a local chiropractor, Jeff Ingleby, D.C., saw his daughter completely heal from an autoimmune disorder with NAET, and decided to take up training in order to offer it to his clients. "Basically, it's using a variety of techniques to reprogram the brain, telling the brain that this food is no longer a danger to you," he explains. I have to stop and think about it, but ultimately, it makes sense—allergies are nothing but a case of mistaken identity, when the brain decides that, say, cat dander or pollens are out to get you, when really they're benign substances. The cascade of events unfolds in the immune system (the swelling and snotting), but it's the brain that's made a bad decision.

Ingleby has seen it work in his family and on his patients; he cured one patient so successfully of her gluten allergy, in fact, she quickly packed on 10 pounds gorging on pizza and bread—finally! Each treatment yields results, he says, though generally it takes about three to five (or more if you're a tough case with multiple sensitivities) to see results. He gives me a demo; I like it enough to decide that at only $30 a pop, it's worth trying it out. After having had my second treatment the day of this writing, I can neither confirm nor deny its long-term success in my own case, but I can already taste that Kepner Melt sandwich, my first planned indulgence in the post-NAET reality. When I chew and swallow with no ill effects, I'll send flowers and kisses to Ingleby and Teitelbaum—they will have restored bageltude to me, a priceless gift.

***

Meanwhile, I stick close to Knoxville's two gluten-free gurus, Prince and a young woman named Courtney Holden, founder of the online gluten-free business Benefit Your Life, which recently opened its first brick-and-mortar store on Campbell Station Road in Farragut, and is in the process of installing a gluten-free bakery. Holden's story is no less poignant than Prince's. She, too, was diagnosed in the year 2000—but with an eating disorder, rather than a gluten sensitivity. "I was vomiting constantly, and I didn't want to eat because everything made me feel so terrible," she remembers. "I'd put in some bread or pasta, and it was like my body would do anything to get rid of it."

She struggled on until the year 2007, when she first "caught wind" of gluten sensitivity. "I thought this might be the key to my problem, so I committed to a gluten-free diet 100 percent for one week," remembers Holden, who is now 29 and pregnant with twins. "And in that week, my life changed 100 percent. Energy was the first thing I noticed—a lot of people think that being tired after you eat a big plate of pasta is normal, but food should give you energy and strength!. Then my skin cleared up, I lost weight, I could sleep, I could think. It was an amazing revelation. I will never go back to gluten."

Like Prince, Holden embraced her new gluten-free life, and decided to make it into a business to help others. Her store offers gluten-free everything—from food to skin care to household cleaners (like I said, wheat turns up in the oddest places). Some gluten-free products can be a negative in terms of nutrition (if you're replacing whole wheat flour with tapioca starch, as some products do). But Holden emphasizes healthfulness as much as prevention. "Our commitment is to offer our clients a net nutritional gain," she says. "We pick and choose the best, because we know we're serving a community that's fighting its way back to health."

According to Prince, there's never been a better time to take up arms in the war on gluten. "There are so many products available now, it's amazing," she says. "And area chefs are really getting sensitive to the needs of their gluten-free customers."

For Prince, a life free of wheat can be a celebration of better and healthier whole foods, not a sentence of mourning for lost carbs. Indeed, she throws regular gluten-free happy hour parties at local restaurants where gluten-free beers and spirits are paired with fabulous gluten-free appetizers. (The next event is at the Northshore Brasserie on May 4 from 5 p.m. to 6:30 p.m.)

Her diagnosis made her into a researcher, and—lucky for me—a reporter, and there's no book more useful to the gluten-free Knoxvillian than My Gluten Free Knoxville. She tells all there is to know about where to go to get your gluten-free supplies, which restaurants in town have gluten-free menus, and how to talk with servers and chefs to get your special dietary needs met. Her favorite gluten-free friendly hot spots? Bonefish Grill, Pei Wei, Tomato Head, P.F. Chang's, Ruth's Chris, RouXbarb, Outback Steakhouse, the Orangery, Lakeside Tavern, and Mulligans.

The key to successfully eating out is speaking up, she says. "Be aware, assume nothing, and be thorough in communicating your needs to your server—or if need be, the chef," she says. "I've had chefs come out of the kitchen and thank me for telling them about what I can and can't eat." In fact, each copy of her book comes with an inserted miniguide to dealing with dining out—if you're too shy to dicker with the staff, just hand it over. Easy peasy.

I use it regularly, and recommend it to others. And though I'm crossing my fingers that NAET will someday put my favorite foods back on the plate, I'm finding that Prince's recipes are lifesavers—particularly her Serious Chocolate Chip Cookies. If I live a life without wheat forever, and it tastes this good, I'll gladly transfer myself into the food handicapable category.